Nigeria’s health sector is once again at a crucial crossroads as the Nigerian Association of Resident Doctors (NARD) has delivered a decisive 24-hour ultimatum to the federal government to fulfil a series of lingering demands. This follows the expiration of a prior 10-day deadline on 10 September, which came with threats of a nationwide walkout unless pressing issues were addressed. As negotiations hit a familiar impasse, the consequences for Nigeria’s already stretched tertiary hospitals loom large.
NARD’s journey toward this critical moment began earlier in September. The group, which represents resident doctors across federal and state health facilities, issued a stern warning on 1 September—resolve outstanding issues within 10 days, or face a broad industrial action. The government’s inaction, as detailed by the association in a communiqué after a virtual emergency National Executive Council (E-NEC) meeting, has now left only a narrow final window for dialogue.
In their statement, the association’s leaders resolved to provide government authorities with one last opportunity to demonstrate genuine commitment. “The E-NEC mandates the NOC to ensure the immediate payment of the outstanding Medical Residency Training Fund (MRTF) within 24 hours and to facilitate the resolution of other pending matters as a demonstration of good faith from the government,” the communiqué noted. If this demand is not met, the union says a five-day warning strike will commence at 8:00 a.m. on Friday, 12 September 2025.
At the heart of these tensions is the unresolved issue of the MRTF—a critical support system designed to bolster medical education for resident doctors. According to NARD, the federal government has continually failed to pay five months’ worth of salary arrears under the 25/35 per cent Consolidated Medical Salary Structure (CONMESS) review, in addition to several other outstanding payments. Many resident doctors, the group claims, remain unpaid despite repeated promises and extensions, causing frustration and uncertainty within Nigeria’s medical workforce.
The E-NEC also voiced concerns about decisions by the Medical and Dental Council of Nigeria (MDCN), namely the alleged downgrading of membership certificates from the prestigious West African Colleges of Physicians and Surgeons—a move that has generated professional uncertainty for many practitioners. NARD further highlighted the inadequacy of responses by state governments, specifically calling out Oyo State’s “woefully inadequate efforts” in addressing the persistent industrial action at the LAUTECH Teaching Hospital in Ogbomosho. The striking doctors there have reportedly received minimal engagement, and the E-NEC labeled state governments’ overall approach to MRTF payments as a sign of gross insensitivity.
This is not the first time NARD has issued strong warnings. In July, the association gave a three-week ultimatum, opting to extend the deadline in the hope that further discussion would deliver progress. But with little to show for these sustained efforts, the patience of frontline healthcare workers is wearing thin. “It is disappointing that our numerous ultimatums have gone unheeded,” said Dr. Akin J. Oladeji, a resident doctor at Lagos University Teaching Hospital. “Doctors are being pushed to the edge.”
The consequences of missed payments and unfulfilled agreements continue to ripple through the entire heathcare landscape. The association has outlined clear prerequisites for calling off any planned strike: immediate disbursement of the 2025 MRTF, settlement of five months of outstanding CONMESS arrears, and the payment of all other allowances due. They also insisted the MDCN restore official recognition of the West African postgraduate membership certificates. In addition, they have called on the National Postgraduate Medical College of Nigeria to expedite certificate issuance for eligible candidates, aligned with global best practices.
“Nigerian doctors spend years investing in their training and service. Timely recognition of their credentials is the least they deserve,” stated Dr. Ifeoma Uba, a health policy specialist in Abuja. This sentiment resonates across the country, particularly in states like Oyo where unresolved grievances have led to prolonged strikes, notably at the LAUTECH Teaching Hospital.
NARD’s demands extend to state authorities as well. The group appealed to Governor Seyi Makinde and his administration to actively address the concerns of striking doctors in Ogbomosho. Broader appeals were also made for state governors to prioritise doctor welfare, ensure regular payment of the MRTF, and develop strategies to curb the emigration of healthcare professionals—a persistent challenge often called a “brain drain.”
Drawing from historical patterns, each strike by resident doctors has had a crippling impact on tertiary healthcare delivery. Resident doctors make up the lion’s share of service providers in Nigeria’s teaching hospitals. When they down tools, critical services—ranging from surgical departments to specialist clinics—grind to a halt, severely impacting patient care. The National Association of Nigerian Nurses and Midwives has in the past expressed solidarity with doctors’ claims, highlighting the ripple effects that industrial actions have in the wider health sector (source: Premium Times Nigeria, 2023).
Amid this tense climate, other medical associations are also resorting to industrial action. The Association of Resident Doctors in the Federal Capital Territory (ARD-FCT) recently embarked on their own seven-day warning strike to express frustration over many of the same issues, including staff shortages, salary delays, unexplained deductions, and the mental health impact of heavy workloads. Local media outlets reported on Tuesday that major hospital departments in Abuja’s teaching hospitals had shut down, leaving only emergency cases being attended to—a scenario mirrored in health centres nationwide.
A representative of ARD-FCT, Dr. Musa Bello, explained, “No new recruitment has taken place in FCT hospitals since 2011, so resident doctors routinely cover several departments. This stretches resources and affects patient care.” Such capacity shortages are not unique to the capital; similar stories are emerging from places like the Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH) in Awka, Anambra, where a seven-day warning strike has also commenced. A patient who gave her name as Ngozi A. described being turned away from outpatient clinics and having to wait hours for emergency treatment, capturing the anxiety felt by many Nigerians during these periodic shutdowns.
Recent statistics from the Nigerian Medical Association (NMA) suggest that Nigeria’s ongoing health worker strikes have contributed to record levels of medical tourism, with Nigerians spending an estimated $1 billion annually seeking treatment abroad (NMA report, 2023). This not only drains finances but highlights the importance of investing in local medical infrastructure and personnel. As Dr. John Olatunde, a Lagos-based healthcare analyst, put it, “No health system can thrive when the backbone of its workforce is left in perpetual uncertainty.”
Comparatively, many West African countries, including Ghana and Senegal, have battled similar disputes between government health officials and medical professionals over pay, working conditions, and training recognition. However, frequent strikes in Nigeria often appear more protracted, in part due to the scale and complexity of the country’s healthcare system.
The situation has drawn the attention of international organisations, including the World Health Organization (WHO), which has repeatedly urged Nigerian authorities to prioritize healthcare worker satisfaction as a prerequisite for robust public health outcomes. “Retention of trained professionals is essential, especially in countries facing evolving public health challenges,” said WHO Nigeria in a recent policy brief.
As the clock ticks down on NARD’s 24-hour ultimatum, all eyes are on the federal government and key stakeholders to either find a sustainable solution or brace for yet another disruptive strike. Nigerians face the sobering reality that without urgent reforms and genuine dialogue, healthcare delivery will remain precarious—a concern not just for Nigeria but for West Africa and the wider African community. The choices made in the coming days will be a litmus test for the future of medical workforce relations in Africa’s most populous nation.
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